Yamamotova Anna, Bulant Josef, Bocek Vaclav, Papezova Hana
Department of Normal, Pathological and Clinical Physiology, Third Faculty of Medicine.
Department of Psychiatry, First Faculty of Medicine.
J Pain Res. 2017 Jul 17;10:1667-1675. doi: 10.2147/JPR.S133425. eCollection 2017.
Body image represents a multidimensional concept including body image evaluation and perception of body appearance. Disturbances of body image perception are considered to be one of the central aspects of anorexia nervosa and bulimia nervosa. There is growing evidence that body image distortion can be associated with changes in pain perception. The aim of our study was to examine the associations between body image perception, body dissatisfaction, and nociception in women with eating disorders and age-matched healthy control women. We measured body dissatisfaction and pain sensitivity in 61 patients with diagnoses of eating disorders (31 anorexia nervosa and 30 bulimia nervosa) and in 30 healthy women. Thermal pain threshold latencies were evaluated using an analgesia meter and body image perception and body dissatisfaction were assessed using Anamorphic Micro software (digital pictures of their own body distorted into larger-body and thinner-body images). Patients with eating disorders overestimated their body size in comparison with healthy controls, but the two groups did not differ in body dissatisfaction. In anorexia and bulimia patient groups, body dissatisfaction (calculated in pixels as desired size/true image size) correlated with pain threshold latencies (=0.55, =0.001), while between body image perception (determined as estimation size/true image size) and pain threshold, no correlation was found. Thus, we demonstrated that in patients with eating disorders, pain perception is significantly associated with emotional contrary to sensory (visual) processing of one's own body image. The more the patients desired to be thin, the more pain-sensitive they were. Our findings based on some shared mechanisms of body dissatisfaction and pain perception support the significance of negative emotions specific for eating disorders and contribute to better understanding of the psychosomatic characteristics of this spectrum of illnesses.
身体意象是一个多维概念，包括身体意象评价和对身体外观的感知。身体意象感知障碍被认为是神经性厌食症和神经性贪食症的核心方面之一。越来越多的证据表明，身体意象扭曲可能与疼痛感知的变化有关。我们研究的目的是检查饮食失调女性与年龄匹配的健康对照女性在身体意象感知、身体不满和伤害感受之间的关联。我们测量了61例诊断为饮食失调的患者（31例神经性厌食症和30例神经性贪食症）以及30例健康女性的身体不满和疼痛敏感性。使用镇痛仪评估热痛阈值潜伏期，并使用变形微软件（将她们自己身体的数码照片扭曲成更大体型和更瘦体型的图像）评估身体意象感知和身体不满。与健康对照相比，饮食失调患者高估了自己的体型，但两组在身体不满方面没有差异。在神经性厌食症和神经性贪食症患者组中，身体不满（以像素计算为期望尺寸/真实图像尺寸）与疼痛阈值潜伏期相关（=0.55，=0.001），而在身体意象感知（确定为估计尺寸/真实图像尺寸）和疼痛阈值之间未发现相关性。因此，我们证明，在饮食失调患者中，疼痛感知与对自身身体意象的情感而非感觉（视觉）加工显著相关。患者越渴望变瘦，他们对疼痛就越敏感。我们基于身体不满和疼痛感知的一些共同机制的研究结果支持了饮食失调特有的负面情绪的重要性，并有助于更好地理解这一系列疾病的身心特征。
